Sick Building Syndrome

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Sick Building Syndrome

In this article

Sick building syndrome (SBS) describes a situation whereby people experience symptoms of ill health that seem to be linked to spending time in a building but where no specific cause can be identified.

The term building-related illness (BRI) refers to recognised diseases, often infections (eg, Legionnaires' disease), caused by being in a building. The cause of SBS is thought to be at least in part due to changes in building and ventilation design triggered by the energy crisis in the 1970s.

One large study found no significant relation between most aspects of the physical work environment and symptom prevalence.[1]

Greater effects were found with features of the psychosocial work environment including high job demands and low support.

The report concluded that the physical environment of office buildings appears to be less important than features of the psychosocial work environment in explaining differences in the prevalence of symptoms.

A subsequent study, found that whilst SBS was associated with poor supervisor support and perception of poor physical environmental conditions at work, an association with poor air quality was also present, even when allowances were made for the psychosocial environment.[2]

Research has shown that SBS shares several symptoms common in other conditions thought to be caused be external factors. The umbrella term 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' has been suggested. Other members of the suggested group include:[3]

Siliconosis.

Macrophagic myofascitis.

The Gulf War syndrome

Post-vaccination phenomena.

Risk factors

SBS is related to both personal and environmental risk factors. Risk factors for SBS include:

Poor ventilation.

High room temperature.

Ineffective cleaning routines.

Poor lighting.

Smoking in the workplace.

Air conditioning.

Low humidity.

Psychological factors such as stress or poor staff morale.

Causes

Internal chemical contaminants: usually air pollutants:

Initial emissions from components and fittings of a building - the 'new smell' generally dissipates over a short period but can last years.

Carbon monoxide, carbon dioxide and other inorganic oxides given off as combustion products in heating systems.[4]

Small fibres from furnishings, regularly agitated into the air by frequent sweeping. Also, asbestos in older buildings.

Tobacco smoke.

External contaminants - outside air entering a building:

Vehicle exhaust fumes: from streets/underground car parks.

Recycling of the building's own exhaust back in through poorly positioned vents/windows.

Other external air pollution or airborne particles (eg, pollen, moulds) have been postulated but the evidence is unconvincing.[5]

The prime suspect in most cases is inadequate ventilation. The factors leading to poor ventilation include insufficient outside air, poor filtration of internal and external air, contaminated duct work, dirty heating, ventilating and air conditioning units, poor planning and placement of vents.

Presentation

General tiredness is often the most common symptom. It usually starts within a few hours of arriving at work and improves within minutes of leaving the building. Symptoms may be worse in the winter months in northern climates:[6]

Headaches and dizziness; headaches are usually non-migrainous, rarely throbbing, and usually described as dull and often as a pressure on the head.[6]

Workplace assessment

Guidance from the Health and Safety Executive (HSE) recommends that employers should:

Carry out an employee survey to see if the occurrence of symptoms is higher than expected.

Check the general cleanliness of the building, the state of all cleaning machinery (eg, vacuum cleaners) and the usage and storage of cleaning materials.

Check the heating, ventilation and air conditioning system.

After any initial steps to resolve the problem have been implemented, it may be necessary to repeat the employee survey and it may be necessary to carry out a more detailed assessment of the workplace environment.

Article Information

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